CPT 76499 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | High |
National average reimbursement for CPT 76499 by major payers:

$1,196.10

$394.94

$400.53

$509.25
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 76499 | ||||||
United | 76499 | $80.90 | 1700801909 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 76499 | $80.90 | 1255640819 - VHS OF ARROWHEAD, INC., ABRAZO ARIZONA HEART HOSPITAL | 621811285 | AZ | General Acute Care Hospital (282N00000X) |
United | 76499 | $91.76 | 1104819366 - CHILDREN'S HOSPITAL | 720467503 - CHILDRENS HOSPITAL INC | LA | Children's Hospital (282NC2000X) |
United | 76499 | $83.80 | 1427098169 - MERCY HOSPITALS EAST COMMUNITIES, MERCY HOSPITAL ST LOUIS | 430653493 - MERCY HOSPITALS EAST COMMUNITIES | MO | General Acute Care Hospital (282N00000X) |
United | 76499 | $182.02 | 1609860360 - OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL, ASSUMPTION COMMUNITY HOSPITAL | 721495500 - (LA) OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL | LA | Rural Acute Care Hospital (282NR1301X) |
United | 76499 | $67.73 | 1033165501 - METHODIST HOSPITALS OF DALLAS, METHODIST RICHARDSON MEDICAL CENTER | 750800661 - METHODIST HOSPITALS OF DALLAS | TX | General Acute Care Hospital (282N00000X) |
United | 76499 | $159.61 | 1205882669 - BRANDON HMA LLC, MERIT HEALTH RANKIN | 640885458 | MS | General Acute Care Hospital (282N00000X) |
United | 76499 | $400.00 | 1124026273 - PROVIDENCE SAINT JOHN'S HEALTH CENTER | 951684082 - (CA) PROVIDENCE SAINT JOHNS HEALTH CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 76499 | $130.44 | 1053972760 - ADVENTHEALTH POLK SOUTH INC, ADVENTHEALTH LAKE WALES | 834672945 | FL | General Acute Care Hospital (282N00000X) |
United | 76499 | $222.47 | 1790297547 - HMH HOSPITALS CORPORATION, JERSEY SHORE UNIVERSITY MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 76499 | $129.44 | 1679875645 - KEMPER CAH, INC., OCHSNER STENNIS HOSPITAL | 271757642 - KEMPER CAH | MS | Critical Access Hospital (282NC0060X) |
United | 76499 | $185.86 | 1528064409 - VIRTUA | 210634532 - VIRTU-WEST JERSEY HEALTH SYSTEM INC | NJ | General Acute Care Hospital (282N00000X) |
United | 76499 | $69.01 | 1063471639 - COMMUNITY HEALTH CENTER OF BRANCH COUNTY | 386108110 - (MI) PROMEDICA COLDWATER REGIONAL HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 76499 | $135.67 | 1225086028 - ST LUKES MEDICAL CENTER LP | 621795587 | AZ | General Acute Care Hospital (282N00000X) |
United | 76499 | $159.61 | 1023061496 - CRESTWOOD HEALTHCARE LP, CRESTWOOD MEDICAL CENTER | 621647983 | AL | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 76499 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 76499 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 76499 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76499. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76499 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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